Skip to main content
SpringerLink
Log in

Transumbilical single-port laparoscopic cholecystectomy

Scarless cholecystectomy

  • New Technology
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Many laparoscopic surgeons have been attempting to reduce incisional morbidity and improve cosmetic outcomes by using fewer and smaller ports. We performed transumbilical single-port laparoscopic cholecystectomy (TUSPLC) in 15 patients with cholelithiasis by using a special “single-port” with virtually no scar.

Methods

We used an extra-small wound retractor and a surgical glove as the “single-port.” The wound retractor was set up through the small umbilical incision and the surgical glove attached with one trocar and two pipes was then fixed to the outer ring of the wound retractor. The commonly used trocar and two slim pipes attached to the surgical glove served as three working channels. Using this single-port and conventional laparoscopic instruments, such as a straight 5-mm dissector, grasper, scissors, and a 30-degree 5-mm rigid laparoscope, we performed TUSPLC in 15 patients with cholelithiasis. The overall procedure was similar to three-port laparoscopic cholecystectomy.

Results

Fifteen well-selected patients with cholelithiasis underwent TUSPLC (4 males and 11 females; mean age, 39 (range, 29–63) years). Body mass index ranged from 20 to 34 (mean, 25.2). No case required extra-umbilical skin incisions or conversion to standard laparoscopy. The mean operative time was 79 (range, 35–165) min. Blood loss was minimal in all cases. The mean postoperative hospital stay was 1.6 (range, 1.0–2.5) days. No postoperative complications were observed.

Conclusions

The results of our initial experience of TUSPLC in 15 well-selected patients with cholelithiasis are encouraging. All procedures were completed successfully within a reasonable time. No extra-umbilical incisions were used and virtually no scar remained. TUSPLC could be a promising alternative method for the treatment of some patients with symptomatic gallstone disease as scarless abdominal surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Yu SC, Yuan RH, Chen SC, Lee WJ (1999) Combined use of mini-laparoscope and conventional laparoscope in laparoscopic cholecystectomy: preservation of minimal invasiveness. J Laparoendosc Adv Surg Tech A 9:57–62

    Article  PubMed  CAS  Google Scholar 

  2. Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16:458–464

    Article  PubMed  CAS  Google Scholar 

  3. Osborne DA, Alexander G, Boe B, Zervos EE (2006) Laparoscopic cholecystectomy: past, present, and future. Surg Technol Int 15:81–85

    PubMed  Google Scholar 

  4. Sarli L, Iusco D, Gobbi S, Porrini C, Ferro M, Roncoroni L (2003) Randomized clinical trial of laparoscopic cholecystectomy performed with mini-instruments. Br J Surg 90:1345–1348

    Article  PubMed  CAS  Google Scholar 

  5. Lee KW, Poon CM, Leung KF, Lee DW, Ko CW (2005) Two-port needlescopic cholecystectomy: prospective study of 100 cases. Hong Kong Med J 11:30–35

    PubMed  CAS  Google Scholar 

  6. Tagaya N, Rokkaku K, Kubota K (2007) Needlescopic cholecystectomy versus needlescope-assisted laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 17:375–379

    Article  PubMed  Google Scholar 

  7. Kagaya T (2001) Laparoscopic cholecystectomy via two ports, using the “Twin-Port” system. J Hepatobiliary Pancreat Surg 8:76–80

    Article  PubMed  CAS  Google Scholar 

  8. Trichak S (2003) Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc 17:1434–1436

    Article  PubMed  CAS  Google Scholar 

  9. Poon CM, Chan KW, Ko CW, Chan KC, Lee DW, Cheung HY, Lee KW (2002) Two-port laparoscopic cholecystectomy: initial results of a modified technique. J Laparoendosc Adv Surg Tech A 12:259–262

    Article  PubMed  Google Scholar 

  10. Leggett PL, Churchman-Winn R, Miller G (2000) Minimizing ports to improve laparoscopic cholecystectomy. Surg Endosc 14:32–36

    Article  PubMed  CAS  Google Scholar 

  11. Scott DJ, Tang SJ, Fernandez R, Bergs R, Goova MT, Zeltser I, Kehdy FJ, Cadeddu JA (2007) Completely transvaginal NOTES cholecystectomy using magnetically anchored instruments. Surg Endosc 21:2308–2316

    Article  PubMed  Google Scholar 

  12. Zornig C, Mofid H, Emmermann A, Alm M, von Waldenfels HA, Felixmuller C (2008) Scarless cholecystectomy with combined transvaginal and transumbilical approach in a series of 20 patients. Surg Endosc 22:1427–1429

    Article  PubMed  CAS  Google Scholar 

  13. Pearl JP, Ponsky JL (2008) Natural orifice translumenal endoscopic surgery: a critical review. J Gastrointest Surg 12:1293–1300

    Article  PubMed  Google Scholar 

  14. Zhu JF, Hu H, Ma YZ, Xu MZ, Li F (2008) Transumbilical endoscopic surgery: a preliminary clinical report. Surg Endosc doi:10.1007/s00464-008-0086-7

  15. Bucher P, Pugin F, Morel P (2008) Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis doi:10.1007/s00384-008-0519-8

  16. Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6

    Article  PubMed  Google Scholar 

  17. Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis doi:10.1111/j.1463-1318.2008.01660.x

  18. Canes D, Desai MM, Aron M, Haber GP, Goel RK, Stein RJ, Kaouk JH, Gill IS (2008) Transumbilical single-port surgery: evolution and current status. Eur Urol doi:10.1016/j.eururo.2008.07.009

  19. Palanivelu C, Rajan PS, Rangarajan M, Parthasarathi R, Senthilnathan P, Praveenraj P (2008) Transumbilical flexible endoscopic cholecystectomy in humans: first feasibility study using a hybrid technique. Endoscopy 40:428–431

    Article  PubMed  CAS  Google Scholar 

  20. Sclabas GM, Swain P, Swanstrom LL (2006) Endoluminal methods for gastrotomy closure in natural orifice transenteric surgery (NOTES). Surg Innov 13:23–30

    Article  PubMed  Google Scholar 

  21. Navarra G, Pozza E, Occhionorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  22. Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361–364

    Article  PubMed  CAS  Google Scholar 

  23. Cuesta MA, Berends F, Veenhof AA (2007) The “invisible cholecystectomy”: a transumbilical laparoscopic operation without a scar. Surg Endosc doi:10.1007/s00464-007-9588-y

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 665 Bupyung-6-dong, Bupyung-gu, Incheon, 403–720, South Korea

    Tae Ho Hong & Keun Ho Lee

  2. Department of Surgery, Kangnam St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea

    Young Kyoung You

Authors
  1. Tae Ho Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Young Kyoung You
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keun Ho Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keun Ho Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hong, T.H., You, Y.K. & Lee, K.H. Transumbilical single-port laparoscopic cholecystectomy. Surg Endosc 23, 1393–1397 (2009). https://doi.org/10.1007/s00464-008-0252-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-008-0252-y

Keywords

Search

Navigation